All posts by Chris Pirillo

Mental health is just as important as physical health. Over the years, I’ve visited more than a few psychiatrists – not because I felt there was anything inherently wrong with me, but because I was looking for professional guidance (and clarity) that could not be self-attained. There’s nothing wrong with admitting that you’re not perfect – because none of us are.

The greatest challenge, for me, isn’t seeing that I could use assistance, but finding the time to sit down with a professional. I always thought it would be more convenient to use my computer to connect with a psychiatrist – and, thanks to a new program for mental health, that’s now possible.

When given the option to interview Arpan Waghray, MD, a System Director for Swedish (Providence St. Joseph Health) who is involved with their Telepsychiatry program, I opted to ask the following questions.

Which party is most hesitant to use this new medium, and why do you think that is?

Patients have generally been very willing to receive care using this medium as it provides more flexibility/convenience and timely access to care. Some elderly patients have had challenges with adapting to the technology but with some assistance from families/caregivers have benefited greatly – especially our home bound elderly patients with depression.

Reimbursement rates continue to remain a problem for many providers to widely adopt this technology as a part of their practice.

With the decreasing costs of available systems and the wider availability of increasingly secure technologies, psychiatrists and patients may find this mode of service more acceptable. The reliable high-speed IP networks that are beginning to form the technological backbone of telepsychiatry are still limited in their reach, being clustered mostly around urban and suburban areas and less prevalent in the rural areas that telepsychiatry could benefit the most.

Has face-to-face interaction been a serious impediment for a would-be patient to have sought traditional psychiatric help?

For many patients with severe depression or anxiety, it might be difficult to schedule and follow up with a traditional office-based psychiatric visit. Some patients struggling with severe postpartum depression might also have to plan for childcare which could limit their ability to receive care.

Children with autistic spectrum disorder might do better in the comfort of there home. Our homebound elderly patients also find it very difficult to receive traditional psychiatric care.

Many psychiatric crisis could be averted by providing timely access to good mental health care. If someone is unwell and unable to visit their mental health provider, the care could be brought to them in a timely manner via Telemedicine that can be tremendously helpful to prevent things from getting worse.

With the advent of the Internet, has self-diagnosis been more of a boon or a bust for a person who may be afflicted with any given mental illness?

We believe that technology, when used appropriately, will help empower our patients to become more informed and involved in their care. With innovation in cloud computing, AI/Machine learning; there could be an ongoing dialogue between physicians and patients using real time data that will lead to better preventive care and more effective, customized health regimens.

Poor information and not involving your healthcare providers, on the other hand, can be detrimental to one`s mental health and well-being.

Apart from the obvious travel savings, can telepsychiatry help save resources for either psychiatrist and/or patients in other ways?

Yes. This technology can allow us to deliver more effective team based models of care. For example, a joint visit with a primary care physician and a Telepsychiatrist can help with developing a shared care care plan that will lead to better outcomes for the patient.

This technology can also help by providing timely access to MH care in rural settings that decreases the need for more expensive and inappropriate healthcare utilization (minimizing avoidable ED visits and hospitalizations).

Does a psychiatrist need to receive special training for the telepsychiatry option?

Being a highly cognitive discipline, psychiatry lends itself somewhat naturally to the use of telemedicine. We do however expect all our providers to have some training to familiarize themselves with the technology with a special focus on ensuring patient safety and privacy.

If the providers need to perform a physical examination, this could be done with the assistance of a Telepresenter at the site of service. There is special training for both the physicians and Telepresenters for this work.

Has telepresence been used effectively in other health care sectors beyond accommodating mental health needs?

Yes. There are several very effective telemedicine programs, including Tele stroke, Tele Hospitalist, Tele Radiology and Tele ICU to name a few.

If given a choice between accessing these services via traditional methods or through these new means, I would absolutely choose the latter (in just about every instance) – for comfort, convenience, and concision. The Internet is not going away, so it’s good to see long-standing institutions embrace its power instead of continuing to exist in a less-than-progressive past.